A week ago The Cherry Tree at Guy’s Hospital was being unveiled. It was a great day. With new plants all around, I am told atrium 2 had never looked better. I hope that patients, staff and families will find it an oasis in the midst of the pressures of hospital life.

And 25 years ago I was at Guy’s as a patient. It was four weeks after my transplant and no sign of the new kidney working. On Good Friday, 13^th, however I was to dialyse for the last time. The kidney was working by Easter Monday.

Although my mind should be focussed on the practical issues of clearing our Kent house before moving to Wales, I find it is racing ahead to my return to Unst. I am getting several new ideas for paintings and how best to show work at Saxavord. I have 2 days in London next week and some places to visit to explore how one or two of my ideas might be shown there. I will report back.

It was the unveiling and dedication yesterday of ‘The Cherry Tree’ at Guy’s Hospital by Alan Titchmarsh and Rowan Williams. I was so glad to be able to honour and pay tribute to all donors of organs for transplantation -  especially the anonymous donor, the friend I never knew,  whose kidney has been my life-saver over the last 25 years. It was good to see again several of the medical professionals whose skill and expertise I have relied upon over the years. My thanks to everyone at the hospital for arranging the event. The cherry tree is made from cut stainless steel. Some has been painted, some has been bent to produce the final effect. The spring blossoming cherry represents new life and I understand a flowering cherry was planted in remembrance of my donor. The work also suggests the cross section of a kidney and the colour change across the work reflects the way a kidney changes colour as it is attached to its new recipient. 

From yesterday's Daily Telegraph:

In 1990, I reported to the Astley Cooper Renal Ward at Guy’s Hospital, nervously clutching an envelope of medical notes from my consultant at my local hospital in Canterbury. I was both excited and apprehensive at the prospect of a kidney transplant which would end my two days a week spent on a dialysis machine. Back then either I nor my doctors had any idea that the new kidney I was about to receive would survive well into the next century.

Recently I returned to Guy’s, not as a patient but as an artist. I'd been commisisoned to create a major new work of art for the central atrium, where many staff, patients and visitors gather. It was commissioned to honour all those who have given organs for transplantation, both living donors and those who in death, have given new hope to others. Designing the work has been poignant for me personally, as it marks the twenty-fifth anniversary of my own transplant. The three metre square wall installation, to be unveiled next Saturday [april 4] by Alan Titchmarsh with a dedication from former archbishop Rowan Williams, shows a cherry tree in blossom. It is made from several hundred pieces of stainless steel, cut to shape and with some of them painted. While it represents new life in general, it has a special significance for me because a flowering cherry was planted several years ago in memory of my own donor.I am amazed, considering the way things went medically, that my transplant is still going strong. I had been diagnosed with kidney failure six years earlier following an illness contracted when reporting for the BBC on an earthquake in Algeria, and had been dialysing for four and a half years. The kidney I received was from a deceased donor, whose name I was never told, although I have corresponded with her family anonymously through the hospital.

 


I still vividly recall how the operation was followed by the longest night of my life. I was in pain, with tubes and drains and drips attached, all of which needed constant monitoring and adjusting. My body rejected the new kidney so fiercely that three days later I was taken back to theatre and surgeon Geoff Koffman had to decide whether to remove it or repair it: he said the new kidney had split open ‘'like a sausage'’. Thankfully he was able to repair it and give it one more chance. Then, for the next four weeks, it refused to work. I continued to be on dialysis and while I could get up and walk around when not attached to the machine, I remained a hospital in-patient. Guy’s became my entire world. I could take short walks in the neighbourhood, but had to return for sleepless nights to my hospital bed.

Today I see much has changed in the vicinity. The hospital tower block that used to dominate the area is now dwarfed by The Shard. The street plan is different and the hospital grounds have been substantially redeveloped. Yet as I walk to the hospital from London Bridge, flashes of memory return. Much has changed too inside the hospital too. It feels a brighter place than I remember and there are no longer gaggles of smokers sitting on the landings outside wards. The transplant ward itself is now relocated and is named after a Victorian pioneer of kidney research Richard Bright. But the most significant changes that have taken place are not immediately visible; they involve the medical technology of transplantation.

Thanks to advances in drug treatment kidney rejection rates have fallen substantially. In my time 30 per cent of transplanted kidneys were lost in the first year, through recipients’ bodies rejecting the new organs as ‘'foreign tissue’'. That rejection figure is now 2 to 3 per cent. This means that while matching a kidney to the recipient remains important, compatibility is no longer as crucial as before. This new generation of anti-rejection drugs has enabled less well-matched organs to be used and for more living donors to offer organs.

Fortunately most people have two kidneys and only one is required for transplant, so a patient can be offered a spare kidney by a relative, spouse or a friend. The advances also mean that “altruistic donors” can offer organs to people they do not know. Surgical improvments also mean that the kidney can be removed by keyhole surgery and the living donor may only have to be in hospital for 3 or 4 days.

Today, says Geoff Koffman, around 50 per cent of the transplants he is involved in are of kidneys from living donors. The operations can be planned and the medical team can be assured the medical history of the kidney being given is fully known. Because of the on-going shortage of organs, sometimes kidneys from deceased donors are only borderline in their viability as they might come from an older donor or one with previously undiagnosed medical issues.

As a result, Geoff Koffman tells patients awaiting transplants, on average a kidney from a deceased donor will last 15 years, but from a living donor 20 years. Transplants like mine that have survived 25 years are now regularly seen, but back in 1990 the techniques of transplantation were relatively new and there too few case histories for valid forecasts to be made.

Twenty-five years ago, I recall how after three weeks of waiting, the renal team decided to give me a new drug to kick-start the kidney into action. Called OKT3 it was a sledge-hammer treatment with the most unpleasant side-effects: I remember being dehydrated and suffering from explosive diarrhoea.

After this treatment I decided I needed a break. It was Easter: on Good Friday I underwent dialysis, little realising then it would be for the last time. The next day was my birthday and I told my doctors I would be going home for one night in my own bed. That evening my wife Helen and I opened a miniature bottle of champagne. I had been given a case of six bottles by a friend, the actor and fourth Dr Who, Tom Baker. “Just what you need” he said, but champagne was not something I had fancied trying until then.

The next day was Easter and we went to a glorious and up-lifting service at Canterbury Cathedral. That night I returned to Guy’s. The next morning something unexpected and remarkable happened. The kidney transplant started to work producing urine. To begin with it was a dribble or two at intervals, which gradually this became a full torrent of activity. Since then I have had no need to dialyse. I can travel without restriction and my life is no longer marred by the cycle of exhaustion and inability to relax that renal failure produces. I can also eat a normal, healthy diet and my fluid restriction is no longer restricted to the equivalent of two cups of tea a day.

Was it the drug, the champagne or the joy of Easter? I don’t know and I don’t need to know. I am simply happy to still be living with the consequences of my transplant; and to have the chance to express in art my gratitude to the donor - the friend I never knew.

From Daily Telegraph http://www.telegraph.co.uk/news/health/news/9128050/Breakthrough-in-kidney-transplant-could-cut-waiting-list.html

We left Unst just after midday on Monday to travel south. There is no feeling quite like the one I feel when taking the ferry across Bluemull Sound heading south. It is a sense of sadness and regret and longing not to have to go away. The longer I have been on Unst, the deeper the feeling. I know some folk who might spend a year on the island without having a single urge to go even as far as Yell. Others need some time in a city, or the sun, to recharge their 21^st century batteries. I am one of those who is very content to stay on Unst!

After some business to attend to in Lerwick, a smooth overnight journey south to Aberdeen. On board a surprise meeting and long chat with an Unst friend also heading south.

From Aberdeen the train south was on time and arrived in London by 5pm. Back in Kent to a freezing cold house by 7.30. Just over 31 hours door to door.

I have checked that everything is ready to put the new artwork up at Guy’s Hospital on Saturday, ready for the official unveiling a week later. 

There used to be a romance about the life cycle of the salmon. There was something mysterious about the way each young fish left its home river and went to sea, only to return to exactly the same place as a mature fish on its way to spawn.

The image of the wild salmon that heads home, overcoming waterfalls and swimming against a rapidly flowing stream, is used subliminally in advertising. Much supermarket smoked Scottish salmon is sold with the logo of a leaping fish. A natural food is the message; raised fresh, clear, island and highland water and air is the image.

But the reality is somewhat different. Modern farmed salmon are raised in great cages in sheltered voes and bays. The product is good. It has made salmon popular and accessible – but somehow the romance has gone.

All day today a helicopter has been flying overhead. Back and for between a hatchery on Unst and a fish carrier ship at Baltasound pier. Each journey involves the helicopter carrying a canister of fish dangling at the end of a wire beneath the aircraft across the hills. Each canister is about the size of a large oil drum and during the whole operation some 150,000 smolts are transported. For each young fish this helicopter ride is its introduction to the big wide world. Scooped from fresh water in their home tanks they are taken in the hold of a ship to their new home. In today’s case the fish are on their way to Westray. So fish that started out as Unst salmon will end up in packaging describing them as from Orkney. Not that they’ll have an identity problem, but the life cycle their ancestors enjoyed is now a thing of the past for today’s modern fish. Freshwater tanks on Unst, brief helicopter ride, a couple of days in the bowels of a ship and then a new life in the sea off Orkney!

It’s been a day of watching the seasonal weather on Unst. Winter at 10 o’clock, spring at 11, Summer by noon and autumn in the early afternoon before reverting to winter again.

After fierce winds rattling the house, suddenly midday today the air went still. Baltasound smoothed over. The generators stopped turning and it was time to venture out for a short walk.

As often happens at this time of year, the fields are full of geese. They come in droves to escape, I presume, the harsher conditions further north.

I have been writing an article about the centenary of the famous poem Flanders’ Field that gave us the poppy as the symbol of remembrance. Previously the poppy had had a rather different image. It was a camp, effete flower on the one hand, mocked by W S Gilbert in Patience, but also the deadly friend of the opium addict.

Now it is worn to honour those killed fighting in the poppy field of Afghanistan. A curious irony. In the First World War the poppy was the first flower to return to the battle fields after they had been churned up and they not only symbolised new life returning, but seen from afar in profusion, they made the fields look blood red.

Heading back to Unst on Monday with the exhibition at Llandaff Cathedral all up - and I think working well. The first 8 stations of the cross are positioned on the stone pillars facing the south aisle and the second 7 on the pillars the other side of the nave. The Forces of Creation, the 15 stations combined into a different work is hung on a screen at the west end of the north aisle and fits perfectly.

It was none too easy hanging the pictures as we had to be careful not to damage the ancient stone work and yet fix everything securely enough to last 40 days. After much trial and error, I think we have succeeded.

On Tuesday I did a long chat with Jason Mohammad on Radio Wales, live on the morning programme. We were given a lot of time to talk about the meaning behind the work and the meaning behind Lent and Shrove Tuesday. It was, I think good radio, dealing with difficult ideas in an accessible way. It is on BBC iplayer at BBC Wales on Tuesday at about 10.20am

Now getting ready for a month back up north during which time I am hoping to sort out the studio after hurriedly leaving a lot of materials up there at the end of last year having brought them from south.

Next back south again to put up the cherry tree wall installation at Guy’s Hospital. All of that now complete. All the pieces are sitting wrapped and in boxes, all cut to shape and painted where required.

I am hoping to get some time over the next four weeks for some painting - lots of ideas I am wanting to try out, and to sort out the galley space alongside the studio for the summer.